EVALUATION OF ARTIFICIAL INTELLIGENCE IN DIAGNOSING SARCOPENIA AND PREDICTING MORTALITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE

 

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EVALUATION OF ARTIFICIAL INTELLIGENCE IN DIAGNOSING SARCOPENIA AND PREDICTING MORTALITY IN PATIENTS WITH CHRONIC KIDNEY DISEASE

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Jihyun
Yang
Hyun Jung Kim hyun_0351.kim@samsung.com Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) -
Yujung Kim yujung57@naver.com Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) -
Ju Young Lee elsta717@gmail.com Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) -
Young Youl Hyun femur0@naver.com Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) -
Changmin Park cmpark3014@claripi.com ClariPi Incorporation Seoul Korea (Republic of) -
Seongkeun Park skpark3014@claripi.com ClariPi Incorporation Seoul Korea (Republic of) -
Kyung Park kkpark3014@claripi.com ClariPi Incorporation Seoul Korea (Republic of) -
Kyu-Beck Lee kyubeck.lee@samsung.com Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) -
Jihyun Yang coo-kie@hanmail.net Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Division of nephrology, Department of Internal medicine Seoul Korea (Republic of) *
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In chronic kidney disease, sarcopenia causes diverse clinical problems and vice versa. Sarcopenia is defined as a reduction in muscle mass and quality, accompanied by a decline in physical performance, and it is difficult to comprehensively evaluate it in actual situations. Therefore, muscle mass measurement is used first currently. While artificial intelligence is being actively applied to diagnosis, interpretation, and treatment planning in various diseases, we compared non-contrast computed tomography (CT) integrated with artificial intelligence (AI) solutions with existing sarcopenia diagnostic methods.

We collected the demographic characteristics, renal function including serum creatinine and dialysis status, and mortality in outpatients or inpatients who had a history of visits nephrology clinic between January 2010 and June 2025. These patients underwent dual-energy X-ray absorptiometry (DXA) and abdominal CT scans within 6-month interval. A single-center retrospective study.

Of a total of 366 patients (180 men, 186 women), 249 patients were diagnosed with sarcopenia with DXA. The median follow-up period was 55.5 months; 29 deaths and 26 dialysis-dependent end-stage kidney disease patients occurred during that time. The mean glomerular filtration rate using the 2021 CKD-EPI formula was 90.3 ml/min/1.73m2. AI-driven total skeletal muscle volume and height-adjusted adhesive muscle mass using DXA showed a significant correlation (Spearman's rho = 0.67, p-value <0.01). Specifically, when the cutoff value was divided into two groups with 1750 cm2, the Receiver Operating Characteristic (ROC) curve showed significant levels of mortality predictive power of sarcopenia with DXA (DXA ROC 0.702, p = 0.01, AI ROC 0.73, p = 0.02) The total skeletal muscle volume also has statistical significance predicting mortality (multivariate Cox regression, HR -0.998 [95% CI 0.996-0.999], p-value 0.01).

This study evaluated whether an AI-based approach utilizing CT scans could serve as a viable alternative to DXA. The findings confirmed that the AI solution can effectively predict both sarcopenia and mortality. In the era of advanced radiomics, AI technologies hold promise for delivering maximal diagnostic information to clinicians with minimal risk to patients.

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